Entries in consumer generated health and wellness content
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The National Cancer Institute reports 2017 U.S. cancer care expenditures were $147+ billion, with anticipated increases from our aging population.

According to Deloitte’s report in Evidence Based Oncology ( The American Journal of Managed Care publication), many organizations are exploring ways to control costs and enhance care quality for oncology patients (e.g. Patient Centered Medical Homes, CMS’ Oncology Care Model).

With many different types of cancer and treatment options, each patient embarks on a personal care journey.

Oncology patients often experience a long journey. Although some steps entail engaging with care staff at a hospital or clinic, most of the time patients are challenged with managing their disease on a daily basis away from the health system.

Healthcare organizations need to closely monitor oncology patients to determine when care and support is required. To be proactive and stay aligned with patient needs, health systems must collect patient information (e.g. Patient Reported Outcomes/PROMs, Patient reported experiences/PREMs). This patient information can guide the care team to intervene, reducing hospitalizations and costs.

“A few years ago, we successfully used a patient engagement care tool with our palliative patients. Our palliative team is embedded within Oncology. Eighteenmonths ago, we introduced this telehealth type of application to our oncology patients. We felt it would be valuable to extend TapCloud to our general oncology patients because we had seen such a positive response using it for those with high symptom burden and advance disease. We believe many patients and caregivers will benefit from having this tool available to use”.

Patient Experience

How does TapCloud support the oncology patient? What is the patient experience?

Last month, Robert (not his real name), a 77 year old patient was diagnosed with prostate cancer. Dr. Twaddle and her staff worked closely with Robert through the onboarding process to provide an overview, demonstrate how to use TapCloud, help him download the TapCloud app onto his phone and iPad and discuss what symptoms they will manage to personalize the app for his specific condition.

The Nurse Coordinator explained “Robert, with this tool (TapCloud), we can think about you when you are not in front of us, get a sense of how you are doing and that we are on the same page”. Robert was relieved to get a message from his Nurse Coordinator confirming that she can see Robert listed on the dashboard to keep a close eye on him.

Most of Dr. Twaddle’s seventy active patients using the TapCloud App are in their 60s and 70s, with a few in their 80s and 90s.

Through the TapCloud app Care Plan, patients like Robert are asked a set of questions. How are you feeling today compared with yesterday? Which of these meds are you taking? Which symptoms are you experiencing today? Symptoms that were selected the prior day are displayed bold. Patients can add symptom(s) which typically takes less than a minute to provide this critical information.

Symptom tracking is made easy by using a word cloud. Each day, the patient sees a personalized word cloud containing symptoms. This personalized symptom cloud incorporates his condition and medications and his list is continuously enhanced from machine learning. TapCloud’s predictive symptoms cover 100+ conditions and 14,000+ side effects. The patient simply touches those symptoms he is noticing. Additionally, he views personalized education based on his journey stage (e.g. tips for managing chemo side effects) and what he is experiencing. He can also upload this biometric information (e.g. vitals, etc.).

How has Northwestern Medicine used the TapCloud tool to deliver better care to Oncology Patients?

Dashboard displays demo data only

Prioritize Patient Outreach. The TapCloud platform analyzes all the patient clinical and self- reported data in real time. Using advanced algorithms, patients with a clinical need are identified and alerts are sent to the care team. Patients are prioritized based on alerts, severity and risk. Nurses use theTapCloud Triage Dashboardto efficiently track, monitor and respond to patients requiring an intervention. Nurses can drill down on a specific patient to see how many days since check in, recent events (e.g. vitals, medication usage), pain and anxiety levels.

Intervene on specific symptoms: Instead of “fishing” for information about how a patient is feeling or having the patient end up in the ER, Nurse Terri can call the patient and say “I've noticed that you've had increased pain the past 2 days…”. TapCloud can also be set up to send alerts for symptoms associated with a patient’s treatment. Patients can send a picture within the TapCloud app with a secure message about their concern.

In the Patient’s Words: “We had one patient who didn’t feel pain but entered ‘yuk’. He selected that to communicate in his words what he was feeling. One of the features that I really like is journaling. A patient may share that today he is ‘discouraged by his illness’. Although he does not expect us to respond, it gives us insight into how he is doing and the support that he may need from us”, shares Dr. Twaddle.

Stay Connected with patients who do not come in regularly: When patients are going through infusion treatment, Dr. Twaddle explained that her team sees them on a frequent basis. “However, when our patients are on oral chemo, we feel that TapCloud is especially valuable to give us a window into their experience. We risk losing them because they cannot tolerate the medications and stop without communicating to us.”

Address Patient Needs with Right Resource: When patients are not in the Clinic or Hospital, it is important to understand what they need. “We may see in a patient’s journaling that she is feeling afraid which is not physical but may be best addressed through our psych- social resource. Or a patient may be ‘running out of her medication’ or ‘checking in on an upcoming appointment’, which can be managed by our Nurse Coordinator."

Measuring Success

Dr. Twaddle uses a set of quantitative and qualitative measures to evaluate the success for the TapCloud solution for oncology patients including:

1) Patient Engagement. How involved are patients in participating in their care? How often did they check in with the app? Which symptoms are most common? What are the new symptoms that have been added by the patient?

3) Cost reduction. How much money was saved by avoiding ER through interventions on symptoms? “When one of our cancer patient ends up in the ER, we explain that we may be able to help avoid the admission with a check in on the TapCloud tool. We had one patient with a side effect that we could have spotted and intervened since it was dangerous for her”.

“We have found that TapCloud is helpful both with cancer patients who have declining function (e.g. pancreatic, advanced lung, brain tumor) and with those that may be curable (e.g. head & neck, breast)", shares Dr. Twaddle.

AMITA Health’s Program will leverage TapCloud

AMITA Health, one of Illinois’s largest health systems is in the process of planning their program which will use TapCloud.

“When I first heard about TapCloud, I was on board immediately”, explains Dr. Robert O. Maganini, Breast Cancer Specialist at AMITA Health. “We have a compliance problem with our breast cancer patients. Although the hormone therapy treatment (e.g. Tamoxifen, Class Aromatase inhibitor) is for five years, some patients will stop after two years because of the side effects. Our working theory is if we have insights into where these patients struggle and when, we can do more aggressive interventions instead of waiting for their next appointment”.

“Our plan is to offer TapCloud to all 200 patients who want to use it, from newly diagnosed to those in year two when we experience a drop in treatment adherence”. After describing his patient population – mostly women 40-75 years old, Dr. Maganini expects a high opt- in rate since it is “ideal for them because it enables faster and more convenient access to their provider”.

Like Dr. Twaddle, Dr. Maganini is planning to use a patient- centric approach when introducing TapCloud, ensuring that patients understand why they are using TapCloud, how to use it, and when to use it.

Dr. Maganini plans to introduce TapCloud to patients at the time of diagnosis. Nurses (e.g. NPs, Navigators) will get patients set up and show them how to use the digital health application. “Since surgery is typically the first step, we plan to use as a follow up with discharge instructions. For those in going through chemo treatments, we will monitor their symptoms. We want to get our patients accustomed to using TapCloud and then they will be using it for the long run with hormone therapy”.

As part of the planning process, Dr. Maganini is working with his team to define the list of side effects including the words that these patients use to describe them. He is leveraging his own and his nursing staff’s patient experiences to devise the TapCloud symptom list in “patient speak”. This is helpful to patients who often struggle to describe their symptoms and feelings.

From this program, Dr. Managini expects to learn about the top side effects, interventions and the effectiveness of the interventions. He will be looking at different success factors – “increase in the therapy completion (3, 4, 5 years) and longer term (beyond the 2 years) hopefully a decrease in mortality rate and reoccurrence”.

“With a program showing demonstrative effectiveness, we envision scaling this to the AMITA Health 2.0, 19 hospitals”, concludes Dr. Managini.

It all started with a simple question one day, and grew into a trusted health relationship a few short months later. Sarah was very busy at work that crisp fall morning and had only a few minutes to log in and ask about her daughter’s diabetes medication. Sarah was comforted by the response and a bit intrigued when her Health AssistantHarriet introduced herself and explained that she is a resource to help her and her family with any of her health questions or concerns. They began a conversation about her daughter’s condition and a trusted relationship began.

Later that week Harriet made a follow up call to see if Sarah was able to pick up her daughter’s medication and asked how everything was going. Sarah mentioned that she finally got her daughter’s pills and confided that she was completely overwhelmed. Sarah shared that she was recently diagnosed with breast cancer and that her husband was often unavailable as he traveled constantly for work. She explained that she had a hard time getting to her treatments. After their call, Harriet explored and evaluated resources, and scheduled transportation to help Sarah get to her next appointment. Harriet put the appointment confirmation into Sarah’s patient portal and set up a reminder, including date and time, about the ride to her next treatment.

This may sound like fiction in the current healthcare environment, where services are siloed and patients are burdened with making their own decisions around healthcare – often complex and costly. Sarah is relieved to have this service today. She first learned from her employer about the Accolade platform and health advisor service last summer. It wasn’t until she reached out with a simple question to her health assistant that Sarah experienced the true value of having a healthcare advisor on her side.

A 2016 Harris Poll reveals that 84% of working families placed a value on having a single, trusted resource to help support their healthcare needs. Busy families have limited time and resources so they appreciate having one place to go to help them understand their options and sort through their healthcare decisions.

Personalized Patient Experience

With the Accolade Health Assistant as the single point of contact for her family, Sarah is able to reach out to Harriet for guidance all along her and her family’s healthcare journeys. Accolade integrates high tech and high touch to deliver a superior patient experience with lower healthcare costs.

Accolade Health Assistant Harriet accesses the Accolade platform to interact with and personalize her support for Sarah:

Preferred Communication: Harriet engages with Sarah and her family based on their communication preferences. Sarah likes phone calls and email through the Accolade online portal. Sarah’s husband Sam prefers secure text messages since he can send quick messages and follow up later during his business trips.

Personalized & Proactive Experience: Harriet’s interactions with Sarah are driven byrich patient profile information, which contains contextual information, social determinants of health and service utilization. Sarah and her family’s profiles are updated withdata collected over time andmore than150 data feeds integrated into the Accolade platform. The HIPAA-certified approach creates profiles that are continuously analyzed through sophisticated algorithms and health assistant reviews, which allow for personalized conversations around individual health needs, care gaps and obstacles.

A recent Accolade platform trigger prompts Harriet to reach out to Sarah’s husband Sam when she notices that he is still refilling this pain medication many weeks after his knee surgery. Harriet sent a text to Sam to inquire about his knee surgery. After a text exchange, Harriett suggested that he see his doctor to discuss his persistent pain.

Patient Education & Connected Health: Sarah and her family canaccess educational information andrecommended health apps. Before Sarah’s husband knee operation, Health Assistant Harriet texted Sam with a link to a video and suggested questions to prepare for his surgery and provider discussion.

When Harriett spoke with Sarah about her daughter’s diabetes appointment and care plan, Harriet informed Sarah about the Livongo mobile diabetes application available through her employer’s health plan. Together, they review the Livongo app, which can help Sarah and her daughter better track and manage her diabetes. With Accolade and Livongo, Sarah is able to share information from the mobile app with her daughter’s doctor, giving him insight into her problems with controlling her A1C levels.

Continuous Connection to Clinical Resources and Support: Harriett asked Sarah if she would like to speak with an oncology nurse to help prepare her for her upcoming oncologist appointment. Margaret, an Accolade Clinical Health Assistant and RN, joined them on the line and offered empathetic support by asking more about Sarah’s diagnosis, where she was in her care plan with her doctor, whether she had a support network and what was planned for her next appointment. Margaret provided Sarah with questions to ask her oncologist and recommended a follow-up discussion.

Intelligent Engagement: Harriet and her Health Assistant team are continuously alerted by the Accolade platform. On an ongoing basis Accolade gathers, aggregates and models de-identified data to trigger alerts and guide Health Assistants in further personalizing their interactions with their clients. Health Assistants are prompted to ask questions about health behaviors and emerging symptoms, applying specialized training and skillset.

Patient Experience Success Measures:

Paul Csigi, Director of Benefits at Philadelphia- based Temple University Health System (TUHS), rolled out the Accolade solution in 2015 and has over 7,000 employees on the platform today. “So much of healthcare is getting people to the right place at the right time. Accolade has created an experience where our employees build a relationship with an assistant that gives them what they need, when they need it. Accolade takes a single problem that the patient has called in about and creates a relationship to support the family on an ongoing basis. With all of the information about our employees, Accolade addresses the whole person, connects the patient with clinical resources, and continues to reach out. This helps treat our employees sooner, which is less expensive for our organization.”

In addition to financial measures, TUHS monitors qualitative feedback from employees. With the Accolade platform outreach (phone or online), TUHS is able to capture the patient’s experience engaging with their Accolade Health Assistant:

“I'd like to thank Temple for the Accolade program. We have been going through some really tough times…..my health assistants have been a big support and a big help to my family in helping to guide us to the right doctors to help with family issues and illnesses. I really appreciate this program. Without it, I'd really be lost.”

“It is great having that person who is able to explain things to you and walk you through the process….It makes navigating the current health care world so much easier and less stressful. That is exactly what you need when you are dealing with a health care issue.”

“I spoke with my health assistant and then with the nurse, and they were incredibly helpful. They spent a lot of time on the phone with me, helping me understand how to navigate the system, and what questions to ask.”

“He [Clinical Health Assistant] made this very difficult hospitalization for my husband an easier journey. Without him, I wouldn't have been able to accomplish many things….I am extremely grateful.”

Patient Experience Journey

With two years of the Accolade solution under their belt, Paul Csigi and his team are considering new ways to support TUHS employees. “I have an employee population with diabetes and heart disease. I am interested in learning more about Accolade’s partnerships to bring patient data into the platform to support these populations.” Csigi sees the benefit of bringing in data from patient devices and smart applications. Integrating this data with the patient’s medical record gives new insights to Accolade Health Assistants, empowering them to deliver even better support and drive improved outcomes.

Dartmouth-Hitchcock (D-H), an innovative New England healthcare system with 1,000+ providers is committed to creating a “sustainable health system”, which proactively engages patients through new care models to achieve the triple aim.

Over the years, D-H has invested in technologies that empower patients to collaborate with providers through shared decision tools and Telehealth, treating “patients and their families as partners in care”.

D-H has been a pioneer in innovative payment models with both the government and commercial payers.

In early 2015, D-H’s leadership team committed to create a truly patient-centric healthcare organization, which delivers high quality proactive personalized care to the patient beyond the hospital walls.

“Dartmouth-Hitchcock purposefully set out to assemble a team of employees with backgrounds from other consumer industries like hospitality and retail that would augment the world-class capabilities of our clinical staff, to improve the health care delivery experience”, explains Vin Fusca, COO, ImagineCare.

With their consumer- centric “healthcare without boundaries” vision, D-H management has designed a truly “care- driven” solution. ImagineCare, a cloud- based platform, enables providers to closely collaborate with each patient to meet her care goals at any time and from anywhere.

With ImagineCare, the Provider and patient have a window into the latest health status for insight and action. In the background, ImagineCare collects information from the patient (i.e. sensor- based devices, apps), combines it with EMR data (i.e. patient visits, labs, meds) and processes it through complex clinical care algorithms with machine intelligence to pinpoint when the patient is at risk. High tech meets high touch when ImagineCare notifies the RN or Health Navigator to reach out to the patient for real-time support and intervention.

“ImagineCare leverages the best available technologies to assist with care, but does not replace the importance of the human touch to drive behavior change. ImagineCare seamlessly combines these components to help patients achieve their health goals”, shares Dr. Ethan Berke, Chief Medical Officer, ImagineCare.

Patient Experience

During her recent doctor’s visit, (patient) Pam decides to participate in D-H’s new ImagineCare Program to help her lose weight and proactively manage her hypertension.

Within 48 hours, Pam receives an email to quickly enroll in ImagineCare and a welcome call to discuss her personal health goals. Two days later a personalized ImagineCare Kit (box) is delivered to her door containing a program overview, a wireless blood pressure cuff and an activity band, devices which fit her selected health goals. Pam follows the instructions to connect her devices to the ImagineCare app.

During enrollment, Pam’s shares her profile information such as personal health goals, challenges, communication preferences, family support, and defines her “medical neighborhood” (i.e. Providers, pharmacy, caregivers). She adds more information when responding to daily questions to create a rich picture about her health needs and resources required to tackle care plan activities.

Anxious about her attempts to lose weight, Pam indicates in the mobile app that she only wants to receive texts to help her stay on track with her weight-management goal.

Through the ImagineCare mobile app, Pam answers daily questions about how she is really doing, while her wireless blood pressure cuff and activity band retrieve and send real-time measures. Pam receives nudges, encouraging messages and digital check-ins to ensure she stays on track with her care plan. Yesterday’s text asked Pam if she was okay since she hadn’t provided her blood pressure as expected.

D-H’s RNs and Health Navigators continuously monitor Pam’s health status, review her trends, and respond to risk warnings by reaching out via text which is her communication preference. Since Pam designates her daughter as a personal health representative within the mobile app, ImagineCare’s RNs are permitted to speak with her about Pam’s health.

ImagineCare Success Measurement

ImagineCare is designed to empower a health care organization to right-size provider visits, lower ED utilization and decrease admission and re-admissions. ImagineCare provides a more engaging solution to help health care delivery systems increase quality of care, decrease cost and improve patient experience.

In addition to these quantitative measures, D-H actively gathers qualitative patient feedback to understand the patient experience. Comments from patients about engaging in the ImagineCare program include:

“I monitor my blood pressure every day, and after a particularly stressful day at the office I went home, took my blood pressure, and five minutes later one of the nurses called and talked me through an immediate care protocol.”

“It has improved my ability to manage my health…The ability to connect with people for support and also send information to my healthcare providers, makes it easier.”

"I am extremely impressed with the ImagineCare phone app. It is very easy to use and seems very intuitive”.

ImagineCare Future

ImagineCare is constantly updating its services and products based on patience engagement data, clinical data, and new technological capabilities coming to market. In a digital health landscape that is becoming more fragmented, ImagineCare will continually create holistic, customer-centered health services to better care for patient populations.

D-H’s team has packaged up the ImagineCare platform for other providers, payers and (self- insured) employers to deliver personalized patient care for better outcomes.

WELLBE PLATFORM FOR PATIENT ENGAGEMENTWith an aging population and increase in chronic conditions including obesity, the demand for hip and knee operation is increasing dramatically. A study in the Journal of Bone & Joint Surgery estimates by 2030 “demand for total hip arthroplasties to grow by 174% to 572,000 and demand for primary total knee arthroplasties by 673% to 3.48 million procedures”.

Responding to this strong demand and high procedure expense, CMS launched the Comprehensive Care for Joint Replacement (CJR) payment bundle April 1st, focusing on cost and quality over a 90-day period beginning with the hospital admission. The CMS CJR Payment bundle is initially for about 800 selected hospitals across the country.

Although Virtua, one of New Jersey’s largest health systems with hospitals, surgical and rehabilitation centers, is voluntarily participating in the BPCI payment bundle, their investment in the orthopedic patient experience at their Joint Replacement Institute (JRI) started long before the payment model changes.

Virtua Health’s Orthopedic Patient Care Journey

Back in 2000, Virtua adopted the Six Sigma methodology and launched the STAR initiative to deliver an "outstanding patient experience”.

“When we look at how we can change and improve a process, we focus on the patient and understand what they need, not what we think they need,” explains Kate Gillespie, AVP of Virtua’s Orthopedic Service Line.

With a commitment to enhancing the orthopedic (hip, knee) surgery experience, Virtua listened to patients discuss their challenges and needs. Through focus group research (Spring 2015), Virtua learned:

• Orthopedic patients need a lot of information to get ready for their surgery but are overwhelmed when inundated with too much at one time.

• Patients place a high value on their doctor’s suggestions to achieve best results.

• Patients that are prepared are more confident and will participate in the process leading to improved outcomes.

“We learned that as patients prepared for surgery, they were asked many of the same questions by different members of our care team,” said Gillespie. “We needed to improve the patient experience and ensure the consistency of information shared along the patient journey. We also wanted to engage the family to support the patient before and after surgery and decided to require that each patient has a ‘care partner’.”

The Virtua JRI team looked for technology to continuously engage patients and families, from on-boarding before surgery, to educating and guiding them from discharge through recovery. The tool needed to be actionable, collecting essential information from the patient (i.e. concerns, pain levels) and informing Nurse Navigators when patients fall off track.

Virtua JRI chose to implement a Connected CarePath for Total Joint Replacement from Wellbe, a solution provider in Madison, Wisconsin. Working closely with Wellbe, Virtua customized their CarePath with their own health history and sleep apnea surveys, scheduling and care plan content (delivered via “CareCards”).

Patient Journey

PATIENT CREATES CARECIRCLE ON WELLBEDuring the initial visit to the surgeon’s office, patient Patty is given information about Wellbe, a personalized care plan for her pre-and post-surgical journey. She signs up with the Nurse Navigator and receives a Welcome email. Patty shares this information and invites her family ‘Care Partner’ to join her CareCircle to access her resources.

Pre- Surgery: Beginning 4-6 weeks prior to surgery, Patty views a care plan with a personalized set of “CareCards” explaining the operation and process to successfully prepare including preadmissions testing and health clearance forms. She receives a “CareCard” introduction to her Nurse Navigator. Every CareCard is delivered “from” her doctor or another member of her care team to motivate compliance. Patty receives reminder messages and checklist items leading up to the surgery and can refer to any completed CareCards in the “library” such as “How to prepare for the day of surgery.”

“Our patients really like the library feature. Before we launched the Wellbe platform, patients were given a Joint Replacement booklet. Now patients and families have all the surgery information at their fingertips. Patients traveling to our Institute can prepare for their surgery by viewing videos instead of attending an in-person class,” adds Gillespie.

Post –Surgery: Within Wellbe, Patty views discharge information such as symptoms to watch for and completes surveys so that her care team can manage her recovery. Patty’s Nurse Navigator monitors her “Progress Report” with required actions and contacts her with any concerns.

“We believe this post-surgery engagement is important to prevent readmissions by ensuring the patient understands how to take medications, manage pain and follow outpatient physical therapy,” Gillespie shares.

Patient Engagement Results

Since launching the Wellbe platform in December 2015, Virtua JRI has enrolled 700 patients. Patients span every socio-economic level and range from 40- 90 years old, with the majority in their 70s.

“We are signing up 86% of our surgery patients which is much higher than we expected. The remaining patients either did not have an email address or didn’t have a friend or family member to help them,” explains Gillespie.

Virtua is evaluating success based on a few factors. Through a Wellbe survey, they are measuring how prepared the patient feels using the platform. With Wellbe reporting, Virtua is also measuring the patient’s engagement and compliance with required CareCards.

Patients have shared positive comments about their experience using the tool - “grateful for the support received”. Nurse Navigators have also provided feedback - the Wellbe platform has helped them be more efficient in their patient care. Through “one tool”, nurses are able to “organize and track patient progress and communicate with the rest of the team” (i.e. physician office, pre-admission testing department).

Virtua has received suggested enhancements such as “defining an end time for a patient to be on the platform” and removing the medication form since patients “already gave the medication list to my surgeon.” Virtua has also added a link to the “Virtua Orthopedic Endowment”, giving patients an opportunity to give back.

Future Opportunities

Virtua initially launched the Wellbe platform without tying it into their Electronic Medical Record. “We are considering integrating Wellbe into our EMR so that the patient’s surgical chart will be easily available on one site for our Nurse Navigator.”

“Wellbe provides a key to patient engagement by keeping them engaged and participating towards a successful surgical journey. Virtua is determining where we can use this tool in other service lines such as Spine, Bariatric, Oncology and Maternity, which are all education-intensive clinical episodes.”

“This program aligns with our vision in keeping our focus on the patient /family experience, and provides us with an opportunities to participate in their surgical journey”, Gillespie concludes.

The Centers for Disease Control and Prevention (CDC) has revealed that 86 million, 1 in 3 Americans now have prediabetes, and 9 out of 10 of them don’t even know they have the condition. Unless there is an intervention, 15% to 30% of people with prediabetes will develop type 2 diabetes within 5 years. The CDC predicts that if current trends continue, 1 in 3 Americans will have diabetes by 2040. On average, diabetes patients cost approximately $10,000 more every year than those without the condition. Like many chronic conditions, risk for type 2 diabetes can be reduced through lifestyle changes.

“We knew that we needed a way to leverage technology to assist our employees who have prediabetes. With our employees spread across 900 locations in North and South Carolina, one huge challenge was figuring out how to motivate employees to participate in a prediabetes program that required them to go to a defined place (building) at a defined time, every week, and do this for 16 weeks.” explains Dr. Zeev Neuwirth, Senior Medical Director of Primary Care at Carolinas HealthCare System.

Carolinas HealthCare System (CHS) was approached by Omada Health with a solution. Omada's online Prevent platform delivers a 16- week National Diabetes Prevention Program recognized by the CDC, with two years of peer-reviewed published data demonstrating effectiveness.

Neuwirth explains further, “We were very interested in the Omada solution. First, it had some really sophisticated and elegant behavior change mechanisms making it much easier for people to create and maintain healthier habits. Second, it was online and asynchronous – meaning that people did not have to show up at a certain time,or certain place. They could use the program from the comfort of their home, and at any time of day or night which makes it much easier for people to sign up and stay with the program. Third, Prevent is based on a proven 16-week program. The Omada platform provides the social connection with a health coach and other participants to sustain behavior change, continuous real-time feedback and daily tasks for habit formation."

“When I participated in the program, I looked at my weight on the Omada scale daily. This led me to be much more aware of my eating and exercise habits. But even more than that, having the bluetooth enabled scale in my house, connected to the coach, I felt like I was part of a larger community, all focused on becoming healthier. Stepping onto that scale almost felt like being transported – the social connectivity factor was much more powerful than I anticipated”, Neuwirth shares.

In early 2015, CHS began offering this solution to employees (called teammates) at risk for developing type 2 diabetes. To promote this new program, CHS leveraged their LiveWell Team which had trusted relationships with teammates across different locations for a “boots on the ground” approach. CHS teammates were emailed a complete Prevent program description, with their participation responsibilities clearly communicated.

Prevent Program includes:

Short online health assessment to determine if you are a candidate

Wireless scale provided to you, for daily weigh-ins

Group of peers who will be your online “team”

Online interactions with a dedicated, professional health coach

Daily and weekly tracking of your progress with your coach and team

Interested teammates clicked on the email link to answer the Prevent screening questions. Qualified teammates enrolled into a cohort of 10-12 anonymous teammates, were assigned to a coach from Omada Health and received a Welcome package with a bluetooth scale.

During the 16-week Prevent “Core” phase, participants complete one interactive health lesson each week, covering physiological, social and psychological aspects for change reinforced with interactive games. After the Core phase, teammates move into the “Sustain” phase with access to more education and a broader peer group for ongoing support.

OMADA HEALTH COACH VIEWTeammates and their coach collaborate via the Omada Health platform. The coach monitors progress and gives real-time feedback via private messaging, group discussion board, text messaging or by phone. Teammates use food and activity trackers to capture high level daily eating, drinking and movement and engage in “healthy competition” messaging with other group members. Cohorts keep them motivated and accountable. Teammates can see the cohort member’s progress towards the weight goal displayed on the group dashboard by a green circle around their profile picture. Only the coach can view each teammate’s detailed progress page with tracked weight, food and activity information.

Prevent Program Positive Response

To date, over 400 teammates have participated in the Prevent program, with 245 completing the 16-week program.

“Teammates have found it beneficial to participate in the program”, explains Kati Davis, Director Benefit Planning and Wellness at Carolinas HealthCare System. “They are guided by trained coaches, supported by cohorts and can participate when it is convenient for them, from wherever they are.. at home or the work.”

CHS is evaluating the program success through quantitative measures (i.e. weight loss, program engagement) and qualitative feedback.

“Although the primary goal was to engage teammates in the program, we have been very happy with the results - 40% of our Prevent participants have lost more than 5% of their weight. When you are considering the risk for prediabetes, this weight loss has a big impact on the health of the teammate.”

“Our teammates are engaging with the Prevent platform an average of 12+ times each week, completing educational lessons, weigh-ins, tracking food/activity, participating in discussions and exchanging private messages with their coach”, Davis adds.

Teammate comments:

The information has been helpful. I know that if I do what it says, I can avoid diabetes. If I don't, I am almost sure to be a diabetic.

Nice to have others going through the same struggles and working together for improvement

Currently in the 9th week of the program and I have lost 17 pounds. I love the app. I hope that at the end of the 16 weeks my scale will continue to work with the app and the tools I have been using will still be there.

Future Direction for Carolinas HealthCare

“We're working to move away from self-reported health activities to activities that require additional accountability and social support”, describes Davis. “We feel the support from the coach and cohort is very powerful to rejoice in the teammate’s success”.

CHS is currently considering to offer the Prevent program to a wider population at risk for Metabolic Syndrome, where weight is an important factor to monitor and manage.

Neuwirth concludes, “From the perspective of a forward-thinking healthcare provider organization, we are excited about the potential of making significant improvements in the health of the multiple populations we care for – our employees, our much larger patient population, and the communities that we serve in the Carolinas. Reducing the number of people who transition from PreDiabetes to Diabetes is one of the largest levers we have to improve the health of populations and communities. What makes this particular Omada Prevent Program attractive to providers and employers is that it makes it a lot easier and much more doable for the people we are trying to help.”